An exception to the following: Telehealth coverage for self-funded plans is based on individual plan coverage.
At Quartz, we're doing all we can to keep you informed during this pandemic. We have several updates on extended timelines for fully-insured commercial members.
Quartz has extended timelines for the COVID-19 viral test:
Quartz will continue to cover the following at 100% through July 31, 2020:
To appropriately waive member cost-sharing for your patients, all provider telehealth claims must have at least one of the telehealth modifiers listed below and listed within our Telehealth Visit Guidelines.
All telemedicine claims must have at least one of these indicators:
95 - Telemedicine Service
CR - Catastrophe/Disaster Related
CS - Subject to a cost-sharing waiver for testing-related services for COVID-19
GT - Via Interactive Audio and Video Telecommunication System
GQ - Via Asynchronous Telecommunication System
GO - Telehealth Services for Diagnosis Evaluation or Treatment of Symptoms of an Acute Stroke
Traditional True Telehealth Services
Historically in-person services now provided via telehealth
POS should equal what it would have been for in-person with modifier 95 to indicate provided by telehealth
|Condition Code (UB)||DR - Disaster Related|
Quartz will provide coverage for all CPT-identified telemedicine codes and codes published by CMS for fee-for-service Medicare. (Note that ASO customers will make their own member cost-sharing decisions.)
Please follow Wisconsin Forward Health coding guidelines.
Visit the ForwardHealth telehealth billing flow chart for BadgerCare Plus members.
COVID-19 viral test: Quartz has extended timelines for waiving cost-sharing for COVID-19 viral tests. There will be no copay, coinsurance or deductible for viral tests performed within or outside of our network through July 25, 2020.
After July 25, 2020, the COVID-19 viral test must be performed by a network provider and will be covered at 100% through March 13, 2021. Members do not need our OK for testing.
COVID-19 antibody tests: No copay, coinsurance or deductible for tests performed in or out of our provider network through July 31, 2020. After July 31, 2020, the test must be performed in our network. Members do not need our OK for testing.
Inpatient treatment related to COVID-19: No copay, coinsurance, or deductible through July 31, 2020, when the provider is in the Quartz network.